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New London - The two ditch diggers who came to the Joseph Lawrence Free Public Hospital on its opening day 100 years ago today probably didn't stop to ponder the historical significance of their actions.
Injured when their Ocean Avenue work site collapsed, those first two patients simply sought the closest available care at the new brick hospital that had just been built with a $100,000 donation by Lawrence's sons with their father's whaling industry wealth. Today, 10 decades, many expansions and modernizations and one merger later, in 1918, the hospital has grown into Lawrence & Memorial Hospital, one of the region's largest and most important institutions and employers, even as it has maintained its community hospital culture.
"L&M has been very important for the development of New London as the center of this region," city historian Sally Ryan said. She first visited the hospital as a teenager, when she needed a tonsillectomy. "It's one of the reasons New London is still a force in the region. Just look at Montauk Avenue, with all the doctors' offices."
Since its founding, the hospital has spread beyond its original location in the mixed residential-commercial neighborhood of Montauk and Ocean avenues, to satellite facilities in Groton, Waterford, East Lyme, Old Saybrook and other local towns, plans for future expansion and affiliations with the Yale-New Haven Hospital, the Joslin Diabetes Center and a new one pending with the Dana Farber Cancer Institute.
"Yet," Ryan said, "it has retained a local flavor."
Jessica Gugliotta of Gales Ferry gave birth to all three of her children at L&M - the most recent on Feb. 29. She said she never thought of going anywhere else, even in this age when hospitals compete for patients with aggressive advertising campaigns. She also brings her oldest son to the hospital for twice-monthly therapy sessions, and has been to L&M's Pequot Health Center in Groton for emergency care.
"It doesn't feel like it's 100 years old," she said. "It's convenient and easy to use. And when I was in the maternity ward, it was insane how many of the people working there I knew. It's nice to feel like you're in a tight community when you're in an uncomfortable situation."
Lately, hospital President and Chief Executive Officer Bruce Cummings has been wondering how L&M's founders and first physicians would react were they to visit today. Surely, he said, they'd marvel at its size, the numbers of employees and patients, and the array of technology and procedures performed.
"I would love to be able to know what our founding mothers and fathers were imagining L&M would be like in 100 years when they were starting this," he said.
The series of events planned to celebrate the centennial anniversary starts today with a special meal for the employees on duty that will be repeated for the rest of the staff throughout the rest of this week. Cummings said the hospital decided to begin the celebration that way in recognition that L&M "still depends (on) and is defined by the people who work here."
"Many of our employees do have an enormous sense of pride in the difference the hospital makes in the region and in the lives of the patients they care for," he said. "It is a big deal for an organization, especially a hospital, to get to be 100."
When the hospital was founded, he noted, New London was home to several smaller hospitals that have since closed. Financially, L&M remained a stable institution, not running deficits like other community hospitals including The Westerly Hospital.
"This hospital has managed to stay in the black when a lot of others were in the red," Dr. Joseph Benedict, a pathologist at L&M for 30 years, said. "Technologywise, they've been very forward looking, always modernizing and rewiring for the present and future."
Overseen by local residents who serve on the 20-member board of directors and comprise its 200-member list of corporators, L&M has retained local control and independence while many other medium and small hospitals have merged with larger institutions.
Naomi Rachleff, 82, was born at L&M and started a lifetime of volunteering there as a candystriper at age 14. Serving on the board and in other capacities, she said, has enabled her to be part of a place that affects many people in direct and positive ways.
"The hospital is the one thing that I thought hit everybody," said the New London resident, now a director emeritus, hospital historian and member of the 100th anniversary committee. "This is where my heart and soul are. Next to raising my children and being a good wife, this is one of the most fulfilling things anyone can do."
When the hospital was founded, medicine in the United States and Europe had just undergone a transformation, said Ralph Arcari, assistant professor in the Department of Community Medicine at the University of Connecticut Medical School. By the end of the 19th century, doctors understood that germs were a major cause of disease and epidemics. Practices such as bleeding and purging of the body had been abandoned and the use of antiseptics, anesthesia and X-rays was accepted.
Many hospitals were being founded in the late 19th and early 20th centuries, he said, out of practical and altruistic motives.
"Public health was seen as a major social responsibility," he said. "People realized that you could risk a whole population by not giving people care."
As medicine became more scientific and reliable, said Naomi Rogers, associate professor of the history of medicine at the Yale School of Medicine, the middle and upper classes came to trust hospitals as the best places for treating illnesses.
"By 1912, the middle and upper classes were seeing hospitals as modern, reliable places," she said.
Before the late 19th century, she said, "hospitals were not considered the best care, and if you could afford to, you'd have a doctor come to the home, or rent a hotel room and bring in the doctors and the nurses."
Today, local residents like Ashley Gauthier and Frances Landry, both of Niantic, can hardly imagine L&M not being there when they need it. Gauthier recently gave birth to her first child there and, throughout her pregnancy, received care at the Joslin center there. Over the years, she's used the emergency department and even had volunteered at L&M in her teens.
"It's expanded and grown so much over the years," she said. "It's close to home, and the nurses are very nice and caring."
Landry, 85, also likes living a few miles from the hospital. In the last half-dozen years, she said, she's been to the emergency room several times, and during a month-long stay after major surgery, her husband was allowed to stay in her room overnight.
"It gives me a lot of security knowing that I'm so close and that it has a very adequate staff," she said. "I've appreciated the excellent care I've been given."
Along with providing health care and a sense of security to local residents, L&M is also an economic force in the region, with half of its annual net revenue of $337 million paying the salaries of its approximately 3,000 workers. For Anne-Marie Kedna Jean-Pierre of Waterford, a surgical technologist, that has meant opportunities to better herself financially and professionally.
An immigrant from Haiti, Jean-Pierre began at L&M 15 years ago as a nurses aide, then trained to become an anesthesia technologist, then advanced to her current job. A 39-year-old mother of two, she is attending Three Rivers Community College part-time to become a registered nurse, with L&M providing tuition assistance.
Like Jean-Pierre, Peter Stelzner has advanced several times during his career at L&M, but in a different corner of the hospital.
"I started here when I was 18, as a broom pusher," said Stelzner, now a 30-year employee. "Over the years, I've gotten my electrical license, my contractors license, my asbestos license."
He is now the hospital's facilities operator, taking care of the boilers, electrical systems and other behind-the-scenes equipment that keep L&M running around the clock.
"This is my 'Why is health care so expensive?' tour," he said, leading the way into the caverns that house the massive power, heating and cooling systems and medical vacuum pumps that provide suction in the operating rooms.
"If that vacuum pump fails," he said, gesturing toward the equipment, "someone in the operating room would be in danger, and if the air conditioning fails, there would be other people in danger. Everything in this hospital is temperature and humidity sensitive."
He continued his behind-the-scenes tour, leading the way into the 100-year-old portion of the hospital that now houses tractors and other grounds-keeping equipment.
"This was the original entrance for the ambulances," he said, pointing to barn-style doors that open toward Ocean Avenue. "When the ambulances would pull up, they'd have to ring the bell."
During his tenure, each time L&M has expanded and upgraded imaging, computers and other equipment, Stelzner said, it has required an increase in electricity and air conditioning.
"That's been the biggest change," he said. "An X-ray machine takes a few amps, and an MRI takes 200 amps."
Keeping up with the latest technology remains a constant challenge for any hospital that wants to remain competitive, and L&M is no exception.
"We're always looking to be on the cutting edge," said Audrey Turner of New London, outreach manager for laboratory services who's worked at L&M for 32 years. "It's always very busy in the lab, but now we're especially busy because we're bringing in a new lab information system."
The new system, she explained, will be tied into the electronic medical records system, another recent addition.
Cummings, the hospital president, said the 100th celebration, which will culminate with a gala May 19 at Mohegan Sun, will both pay homage to L&M's past and focus on what's ahead. Corporate and individual donations raised at the $100-per-person gala will go toward a new cancer center, a major component of the planned expansion and renovation plans.
"Cancer is so prominent with the aging of our population," he said. "With Connecticut having one of the highest cancer rates in the country, and New London County having the highest in Connecticut, we wanted to make a strong statement that we will be providing the very best cancer care. This is an important watershed moment."
Excerpts from first annual report of the Joseph Lawrence Free Public Hospital, published April 1, 1913:
From the section regarding patients:
"Insane persons and those suffering from contagious diseases or from uncomplicated pulmonary tuberculosis shall not be admitted to the hospital. Persons suffering from venereal diseases shall not be admitted, neither shall incurable cases be admitted."
"Patients receiving charity are expected to show a readiness to oblige one another, and to assist in such services in the wards as their health enables them to perform, remembering that they have come into a household of which the great law is that of mutual kindness and brotherly love."
"Each patient shall be responsible for the neatness of his bed when not occupied, during the day; before lying down upon it, he must remove his boots or shoes."
"There shall be no loud talking, no profane or vulgar language, and no unnecessary noise or disturbance ..."
"Patients shall not be furnished with fruit, or other articles of food, without the knowledge and permission of the Superintendent-matron."
"Spitting on the floor or other practices inconsistent with neatness, cleanliness and the customs of respectable society, must be avoided."
From the section on charges:
"It is the desire and intention of the trustees to make the hospital service free to the poor, so far as the income will permit ..."
"For those able to pay and those who desire private rooms, prices have been fixed as follows, which includes nursing, ordinary medicine and washing."
Private room: $15
Private room with private bath: $25
Some of the most common conditions of patients:
Bronchitis, typhoid fever, pneumonia, chronic nephritis with cardiac hypertrophy, endometritis, prolapse of uterus, oophoritis, childbirth (43), appendicitis, abdominal abscess, fractures, hernias, phimosis, gunshot wounds; tonsillitis.
Most common occupations of patients:
Bootblack, butcher, clerk, salesman, dock hand, dressmaker, engineer, farmer, housemaid, housewife, general laborer, insurance agent, laundress, machinist, mill hand, school child, teamster.
By the numbers
• Satellite facilities: 0
• Total patient visits: 482
• Doctors: 13
• Satellite facilities: 9
• Total patient visits: 75,956
• Doctors: 442